What is a headache, how is it different from a migraine?

Tension headache

Tension headaches are the most common form of headache - a dull ache, with pressure around the front, top and sides of the head; you may have neck tension and/or a feeling of pressure behind the eyes.  Normally you'll be able to carry on, and it may last half an hour, a few hours or a few days.  If they start to become severe, or happening weekly, this is not normal.


A migraine is more debilitating than a headache, and you may get other symptoms which go with it.

Migraine symptoms can include:

  • Pounding pain to one or both sides of the head
  • Nausea which may or may not be followed by vomiting
  • Increased sensitivity - to light, sound, smells
  • Poor concentration
  • Sweating
  • Feeling very hot or very cold
  • Abdominal pain - sometimes leading to diarrhoea
  • Frequent need to urinate

Symptoms can last between 4 hours and 3 days.  You may feel tired for up to 7 days after a migraine attack.

Some will get an "aura" as a warning sign, before a migraine begins - others will get visual disturbances, such as flashing lights, or stiffness or tingling in the neck, shoulders or limbs.  Sometimes there are all the symptoms of migraine, but the headache does not develop.

What causes headaches and migraines

Tension headaches:

  • Stress and anxiety
  • Squinting
  • Tiredness
  • Dehydration
  • Skipping meals
  • Lack of exercise or physical activity
  • Bright sunlight
  • Noise
  • Certain smells
  • Poor posture

Migraine - causes:

It is thought that serotonin in the brain decreases during a migraine, which can make the blood vessels in part of the brain spasm, making them narrower - this is thought to cause the symptoms of aura.  The headache is then caused when the blood vessels dilate.  The reason for the serotonin drop is not fully understood.  Another cited cause are fluctuating hormone levels - with migraine related to the menstrual cycle.

Other triggers:


  • Stress and anxiety
  • Depression
  • Excitement
  • Tiredness


  • Low blood sugar
  • Shift work or travelling for a long period
  • Poor posture
  • Bright lights
  • Flickering screens: TV / computer
  • Noise
  • Weather changes: humidity or temperature; stuffiness
  • Strong smells


  • Some sleeping pills
  • Contraceptive pill
  • HRT


(See Lifestyle advice below)

Conventional treatment for headaches and migraines?

Tension headaches:

  • Painkillers such as paracetamol, ibuprofen or aspirin might be recommended
  • Sometimes tricyclic antidepressants which act on nerve cells in the brain, can be prescribed for chronic tension type headaches
  • Lifestyle advice to reduce stress


There's not specific test to diagnose migraines, your GP will look for a pattern of recurring headaches with associated symptoms.  The GP will ask questions about the location and nature of the pain, any triggers and how it affects you.

Treatment offered may include:

  • Painkillers including paracetamol and aspirin
  • If painkillers aren't working triptan medicines that cause the blood vessels around the brain to contract may be prescribed
  • Anti-inflammatories are sometimes suggested eg. ibuprofen, diclofenac, naproxen and tolfenamic acid
  • Anti-sickness medicines are sometimes used even if nausea isn't a symptom
  • Migraine clinics - may be recommended if your migraine isn't responding to treatment

How do I treat headaches and migraines?


Identifies food, drink or environmental triggers.  You will be given a list of what has been tested, highlighting those to avoid.

Common problems are: sugar, aged cheese, coffee, tea, alcohol, chocolate, MSG, citrus fruit, stoned fruit, aspartame, some perfumes


Guidelines from the National Institute for Health and Care Excellence (NICE) states that a course of up to 10 sessions of acupuncture over a 5-8 week period may be beneficial in preventing chronic tension-type headaches.

I will treat using acupuncture by moving energy - typically that of the Liver and Gall Bladder, whilst also tonifying any underlying deficiency of energy.


  • Specifically on the pain or tension
  • To address any on-going stress
  • To address any emotional issues you connect with your symptoms.  (Louise Hay suggests headache may indicate "self-criticism, invalidating the self or fear".  For migraine she suggests, "dislike of being driven, resisting the flow of life, or sexual fears.")  Of course these may not apply to you, but generally there is some element of frustration, anger or resentment that coincides with headaches and migraine.

Effectiveness of treatment

With the discipline to avoid the trigger foods, together with acupuncture, a good prognosis can be expected.  It may take a few treatments to notice a difference, or you may find you arrive with a headache, which is gone by the end of treatment - it varies from patient to patient.


The British Acupuncture has research discussing the efficacy of acupuncture for headaches, which includes:

Vickers AJ et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ 2004; 328: 744

"The researchers concluded that acupuncture leads to lasting benefits for patients with chronic headache, particularly migraine, and that expansion of NHS acupuncture services should be considered."

Each case is slightly different, so to discuss your symptoms further call 020 7370 4693 or email.

A case study from my clinic

Isabelle 32 years: chronic headaches

Isabelle had very debilitating headaches and tension which had become worse and worse over the last year.  The headaches coincided with extreme stress from her biggest client, and working very long hours.  Other symptoms included grinding her teeth, neck and shoulder tension, anxiety, nausea, a long menstrual cycle and cramps with period.

The symptoms are indicative of Liver Qi Stagnation caused by stress, with underlying deficiency.

Initially I tested out food, drink and environmental triggers, kinesthetically.  We found a sensitivity to cheese, chocolate, coffee, sugar, tea, wheat, yeast and prawns.  Isabelle cut these out from her diet.

Acupuncture was used on points on the legs, hands and head - to clear Liver Qi Stagnation, and the tension in the jaw and shoulders.  I also nourished the Kidneys and Bladder.

EFT was used for specific pain, using a technique called "chasing the pain".

The pain had not totally disappeared at the end of the first treatment, but over the next week, the tension around the back of the head had reduced from a continuous 6/10 (where 10 is bad) to 1/10.  The neck felt much better.  She was still grinding her teeth at night.  After a second treatment, two weeks later, she reported, "no headaches at all, my head feels great!"  She also noticed her attitude to her work was now really positive - whereas before it was pure stressThere was slight tension in the shoulder.  After the third treatment, Isabelle dropped treatment down to once every 2 weeks, and then down to once every 3-4 weeks.

She still comes every 3-4 weeks to remain emotionally positive, balance stress and keep the headaches at bay.  Over the past year there have been one or two headaches, which co-inside with stress.

Lifestyle advice for headaches and migraines

Keep a diary of the pattern of your headaches or migraine, and notice any patterns: stress or emotional, food, sleep, dehydration, concentration, cycle related - or any other factors.


Drink lots of water - at least 2 litres a day.  Avoid processed food.

Specific headache triggers can include: sugar, aged cheese, coffee, tea, alcohol, chocolate, MSG, citrus fruit, stoned fruit and aspartame.

Try to eat a low GI diet - this will keep blood sugar levels stable - sometimes a cause of headache.

Stress reducing tips

In my experience stress is a big contributor to headaches, so:

  • Get good rest, at least 8 hours a night, the more before midnight the better
  • Take a walk in nature: the countryside or a park
  • Try yoga, Qi Gong or Tai Chi
  • Engage your creativity: painting, playing an instrument, taking pictures, creative writing (start with a journal)
  • Avoid over obsessing about emails, texts and the internet
  • Anything to provide balance to counteract a busy life

Ask yourself, what do I do to relax?  I hope you have an answer!  If so, make time for it.  If not - play and find out.


Patrick Holford, from Institute of Optimum Nutrition recommends taking 100-200mg of vitamin B3 in the niacin form, which is a vascodilator, although it will cause a "blushing" sensation, so start with a small dose. Take when you can lie down and relax.


If your headaches or migraine are due to bad deportment or structural problems, a few physio sessions, or regular pilates might help.